The Family Research Council, an organization of religious and social conservatives, sends a letter to the Department of Health and Human Services (HHS) protesting a department Web site that for six years has provided the public with information about gay-related health issues. Two weeks later, the entire Web site disappears. [Savage, 2007, pp. 106]

Betsy McCaughey (R-NY), the former lieutenant governor of New York and a fellow at the conservative Hudson Institute, writes that health care provisions in the Obama administration’s economic stimulus plan will affect “every individual in the United States.” McCaughey writes: “Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors. But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and ‘guide’ your doctor’s decisions.” McCaughey says the provisions are similar to suggestions in the book Critical: What We Can Do About the Health Care Crisis, by former Senate Majority Leader Tom Daschle (D-SD), until recently Obama’s pick to head the Department of Health and Human Services. McCaughey writes that hospitals and doctors who do not use the system will be punished, by a federal oversight board to be called the Federal Coordinating Council for Comparative Effectiveness Research. Perhaps most worrisome is McCaughey’s claim that elderly Americans will be given reduced health care based on their age and expected productivity. “Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council,” she writes. “The Federal Council is modeled after a UK board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis. In 2006, a UK health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.… If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the US will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later. The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined.” [Bloomberg News, 2/9/2009] McCaughey’s claims are very similar to the ones she made against the Clinton administration’s attempt to reform health care in 1994 (see Mid-January - February 4, 1994). They will be proven false (see July 23, 2009).

According to media reports, the Obama administration intends to reverse the “right of conscience rule,” formally called the Provider Refusal Rule, for health care workers enacted by President Bush in the last weeks of his term. In December 2008, Bush issued an executive order allowing health care workers to deny care based on their personal beliefs. The order was issued to target doctors and nurses who do not want to provide abortions, even if they work in a facility that offers abortions to clients. Specifically, the rule denies Department of Health and Human Services (HHS) funding to institutions that do not allow workers to refuse care that goes against their beliefs. Now the Obama administration says President Obama will override that order. Seven states have already challenged the rule, claiming it sacrifices the health of patients in order to satisfy the religious or moral beliefs of medical personnel. The American College of Obstetrics and Gynecology has reported cases such as that of a Virginia mother of two who became pregnant because she was denied emergency contraception; in Texas, the group said, a rape victim had her prescription for emergency contraception rejected by a pharmacist. Obama has already overturned a ban on US funding for international aid groups that provide abortion services. However, administration officials say the administration may consider a rule that would clarify what health care workers can reasonably refuse. An HHS spokesman says: “We recognize and understand that some providers have objections to providing abortions. But we do not want to impose new limitations on services that would allow providers to refuse to provide to women and their families services like family planning and contraception that would actually help prevent the need for an abortion in the first place.” Dr. Suzanne Poppema of Physicians for Reproductive Choice and Health praises Obama “for placing good health care above ideological demands,” and says: “Physicians across the country were outraged when the Bush administration, in its final days, limited women’s access to reproductive health care. Hundreds of doctors protested these midnight regulations and urged President Obama to repeal them quickly. We are thrilled that President Obama took the first steps today to ensure that our patients’ health is once again protected.” Tony Perkins of the anti-abortion Family Research Council (FRC) counters: “Protecting the right of all health care providers to make professional judgments based on moral convictions and ethical standards is foundational to federal law and is necessary to ensure that access to health care is not diminished, which will occur if health care workers are forced out of their jobs because of their ethical stances. President Obama’s intention to change the language of these protections would result in the government becoming the conscience and not the individual. It is a person’s right to exercise their moral judgment, not the government’s to decide it for them.” [Chicago Tribune, 2/27/2009; CNN, 2/27/2009; New York Times, 2/27/2009] The liberal Center for American Progress (CAP) writes in April 2009: “Conservatives have criticized the Obama administration for infringing upon the conscience of health care professionals and ‘forcing’ them to provide abortion services.… Yet this assertion could not be further from the truth. President Obama’s proposal to rescind Bush’s last-minute rule restores the pre-existing compromise established through decades of debate.” CAP notes that Title VII of the Civil Rights Act disallows employers from firing or harassing workers who decline to fulfill assigned tasks due to moral or religious objections. “Obama’s proposal to rescind the Bush ‘conscience’ rule simply restores the prior balance that existed on matters of conscience,” CAP concludes. “It once again guides the health care system to value the consciences of health care providers and patients.” [Jessica Arons and Sarah Dreier, 4/28/2009] However, for reasons never made publicly clear, the Obama administration will never actually rescind the order. It is possible that Obama or HHS officials bow to pressure from a number of organizations such as the FRC and the Christian Medical Association, which have continually pressured the administration not to rescind the order. [Fox News, 4/8/2009; Time, 2/4/2010; Megan Sullivan, 7/13/2010]

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